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HmarieD's Latest Activity

  1. HmarieD

    Missed visit?

    The physician must be notified of any variance from the plan of care, i.e. missed visits. It is not necessary to write a new frequency order as long as you have documentation of the missed visit, reason, and MD notification. We have a specific form we complete for this purpose.
  2. HmarieD

    Motivating the Nurse in All of Us

    I am so sorry you are going through this, and I totally get it... I felt the same way. I thought I had made the worst mistake of my life by becoming a nurse. Luckily, I was able to move to a specialty area that I love. I started in Home Health and it was like the clouds parted for me, I've been doing this for 12 years and never looked back. You should look around at other opportunities, there are so many things you can do as a nurse that one of them is bound to be just the thing for you. Good luck.
  3. HmarieD

    What would you do?

    No, I wouldn't just show up on the off chance that I would be able to work. However, I would think that the nurse or her agency would have been monitoring his status so they would know when he was discharged home. Having said that, did you notify the agency that your son was home and his care should resume?
  4. HmarieD

    You may not be homebound if....

    You may not be homebound if...you brag to me about the hot babe you bagged when you hit all the bars on your birthday.
  5. HmarieD

    Advice needed

    This forum is specific to Home Health, I think there is a Hospice forum you might have better responses from. Good luck.
  6. HmarieD

    Butter, ice cream, and baseball

    I always ask the same question! My favorite response was the gentleman who, every morning, drank 2 oz of red wine mixed with OJ. Now that's a health craze I can get behind!
  7. HmarieD


    Remember that every single clinical note must stand alone, in other words you should be painting a very complete clinical picture every time you document. Your documentation of tasks such as wound care must echo your plan of care, and should be in excruciating detail (cleanse w/___, apply___, cover w/___, secure w/___, aseptic technique). Remember to document any and all care coordination (communication with any member of the health care team including caregivers, DME providers, physicians, clinical supervisors, etc etc). Always address progress (or lack of progress) toward goals as they are stated on the plan of care. Always make sure you are demonstrating homebound status if applicable, and skilled need and medical necessity. Indicate why the pt continues to require HH services. These are just some of the areas I do not see done well when I audit a record.
  8. HmarieD

    Tracking nursing activities

    This is a new billing requirement of Medicare, the agency must assign G-codes to each visit to indicate what type of service was provided. Be glad your agency is asking you to do this, a lot of places have just chosen one code to assign to every visit.
  9. HmarieD

    wearing makeup to work?

    For those with the "raccoon eyes" issue, I have recently discovered Loreal beauty tubes mascara, it is the only kind I have ever used that doesn't do that. It's amazing!
  10. HmarieD

    Face-to-Face Rule

    Good News!! CMS has decided to postpone the enforcement of this new reg until the 2nd quarter of 2011. They recommend agencies go ahead and begin complying with the f2f requirement now to trouble-shoot, but will not enforce at this time. WooHoo!!!
  11. HmarieD

    Should i consider taking this job?

    I don't know what STNA is either, and I have worked in HH a long time, though in another state. There is a Home Health thread or forum (?) here that might net you more responses. Good luck!
  12. HmarieD

    Help On sensory deprivation

    Try http://www.medscape.com
  13. HmarieD

    Recommended Home Health Agencies

    The burdensome paperwork is usually what drives people away from Home Health. I doubt that there are any agencies requesting paperwork that is not required or necessary for quality care and compliance, as the requirements are indeed difficult to manage. Good luck.
  14. HmarieD

    IS Gluttony a Disease or Choice?

    I once weighed about 150 lbs, 5'4". Thick, but not terribly obese. I began taking Effexor and immediately began gaining weight. I began to change my diet, which had never been bad, to include lots of whole grains, fresh fruits & veggies, water instead of soda, etc. Even with all these changes, I gained 75 lbs in a period of about a year and a half. Now at 225 lbs and being no taller, I am definitely obese. So, am I a glutton or is my obesity a disease? Or, perhaps, might this be a terribly complex issue with as many explanations as there are obese people?
  15. HmarieD

    Men in home health

    I work with two male RNs, doing intermittent HH. To my knowledge, no one has ever complained about having them, and one of them has lol pts that freak out if he has to be replaced for a visit or two. I think you may have hit the nail on the head, the agency you spoke to is stuck in 1960.
  16. HmarieD

    New to Home Health

    I recommend calling the day before. This can save you a lot of grief in revising your schedule when you discover the pt has an MD appt, family visiting, or, my personal favorite, they are too sick for the nurse to come. I also think it's more courteous to the pt.